Role of Conservative Management in Neck Trauma: A Case Series Study

Document Type: Original Article

Authors

1 Thoracic Surgeon, Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 General Surgeon, Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Thoracic Surgeon, Cardio-Thoracic Surgery & Transplant Research Center, Emam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Community Medicine Specialist, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction: There are significant gender differences in the epidemiology and presentation of cardiovascular diseases (CVDs), physiological aspects of CVDs, response to diagnostic tests or interventions, and prevalence or incidence of the associated risk factors. Considering the independent influence of gender on early dire consequences of such diseases, this study was conducted to investigate gender differences in patients' beliefs about biological, environmental, behavioral, and psychological risk factors in a cardiac rehabilitation program.
Materials and Methods: This study has cross sectional design. The sample was composed of 775 patients referred to cardiac rehabilitation unit in Imam Ali Hospital in Kermanshah, Iran. The data were collected using clinical interview and patients’ medical records. The data were analyzed using descriptive statistics such as mean, standard deviation, and chi-square test​​. To do the statistical analysis, SPSS version 20 was utilized.
Results: As the results indicated, there was a significant difference between the beliefs of men and women about risk factors of heart disease (X2= 48.36; P<0.01). Men considered behavioral (55.1%) and psychological (33.7%) risk factors as the main causes of their disease, respectively. On the other hand, women regarded psychological (38.2%) and behavioral factors (26.6%) as the most common causes of cardiac conditions, respectively. Both men and women considered stress as the most important heart disease risk factor (21% and 22.3%, respectively). Also, women were less aware of the risk factors, compared to men.
Conclusion: From the patients’ perspective, psychological and behavioral risk factors were the most important causes of cardiovascular diseases (CVDs); moreover, stress was the most influential risk factor for developing cardiac diseases. Thus, learning to control and manage these risk factors can help to prevent the development of CVDs and reduce the occurrence of subsequent cardiac events. 
 

Keywords


1- Ionathan. C: Penetrating and Blunt Neck Trauma 10 year experience, Canada J surg, 1997, 40: 840-845
2-Saletta. D: Penetrating Trauma of The Neck, J. Trauma, 1996, 579-584
3- Sethi RK, Kozin ED, Fagenholz PJ, Lee DJ, Shrime MG, Gray ST. Epidemiological Survey of Head and Neck Injuries and Trauma in the United States. Otolaryngol Head Neck Surg. 2014 Aug 19. pii: 0194599814546112. [Epub ahead of print]
4- Schaefer SD. Management of acute blunt and penetrating external laryngeal trauma. Laryngoscope. 2014;124:233-44.
5- Rivkind. A: Penetrating Neck Trauma, J. Surg, 2001, 46: 113-116
6- Narrod JA, Moore EE: Selective Management of Penetrating Neck Injury, Arch Surg, 1994, 119: 574-8
7- Fogelman MJ, Stewart RD: Penetrating Wound of The Neck, An, J. Surg, 1996, 91: 581-96
8- Siegrist B, Steeb G: Penetrating Neck Injuries, South Med. J, 2000, 93: 567-570
9- Peter T. Masiakos,George C. Velmahos. Neck Injuries. Fundamentals of Pediatric Surgery.2011 ;23: 117-121
10- Steenburg, Scott D. "Imaging Evaluation of Penetrating Neck Injuries." Radiographics 2010 ;30: 869-886
11- Lugman. Z: Penetrating Pharyngeal Injuries in Children: trivial trauma leading to devastating complications, Pediatr Surg Int, 2005, 21: 432-435
12- Konobu T, Nakamura T, Hata M, Ueyama T, Norimoto K, Fukushima H, Murao Y, Okuchi K: Acute Penetrating Neck Trauma Presenting with Laryngotracheal Injury, Kyaobu Geka, 2005, 58: 475-80
13- Selefan. S: The Role of Angiography in Penetrating Neck Trauma, J. Trauma, 1991, 31: 520-525
14- Ferguson E, Dennis JW, Vu JH, Frykberg ER: Redefining The Role of Arterial Imaging in The Management of Penetrating Zone 3 Neck Injuries, Vascular, 2005, 31: 158-163
15- Munera F, Cohn S, Rivas LA: Penetrating Injuries of The Neck: use of helical computed tomographic angiography, J trauma, 2005, 58: 413-418
16- Fernando A. Herrera, Joseph A. Mareno, David Easter. Management. J Surg Educ 2007: 64;75-78
17- Ordog. G: Penetrating Neck Trauma, J Trauma, 1987, 25: 543-554
18- Kayhan Ozturk,Bahar Keles,Ziya Cenik,Huseyin Yaman. Penetrating zone II neck injury by broken wind shield. Int Wound J 2006; 3; 63-66